| Smile Max Dental | |
|
2969 Harbor Blvd. Costa Mesa CA 92626 | |
| (714) 437-1100 | |
| (714) 437-1101 |
| Full Name | Smile Max Dental |
|---|---|
| Speciality | Dentist |
| Location | 2969 Harbor Blvd., Costa Mesa, California |
| Authorized Official Name and Position | Matt G Farzin (DENTIST) |
| Authorized Official Contact | 9498128014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Max Dental 2969 Harbor Blvd Costa Mesa CA 92626-3912 Ph: (714) 437-1100 | Smile Max Dental 2969 Harbor Blvd. Costa Mesa CA 92626 Ph: (714) 437-1100 |
| NPI Number | 1487913471 |
|---|---|
| Provider Enumeration Date | 05/10/2012 |
| Last Update Date | 05/01/2024 |
| Medicare PECOS PAC ID | 9335409523 |
|---|---|
| Medicare Enrollment ID | O20180208000831 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487913471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 53595 (California) | Primary |
| Provider Name | Matt G Farzin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1386783108 PECOS PAC ID: 8527328715 Enrollment ID: I20180215001519 |
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